The contribution of nurses to the care of resident of nursing homes - keeping all strings in one's hand.

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinnTil að tryggja þau gæði, sem eru grundvallaratriði fyrir vellíðan heimilismanna á hjúkrunarheimilum, er nauðsynlegt að greina framlag hjúkrunarfræðinga til hjúkrunar aldraðra. Tilgangur þessarar eigindlegu rannsóknar var að varpa ljósi á viðfangsefni hjúkrunarfræðinga á hjúkrunarheimilum og lýsa því í hverju störf þeirra eru fólgin. Tekin voru fjögur rýnihópaviðtöl við samtals 22 hjúkrunarfræðinga frá fimm hjúkrunarheimilum. Notaður var hálfstaðlaður viðtalsrammi. Viðtölin voru þemagreind. Niðurstöður sýndu fjölþætt og flókin viðfangsefni hjúkrunarfræðinga. yfirþemað var að hafa alla þræði starfseminnar í hendi sér. Undirþemun voru árvekni, að hafa yfirsýn og vera vakandi yfir öllu og að vera greinandi og sjá hlutina í öðru ljósi. Á grundvelli þess fjárhagslega umhverfis, sem hjúkrunarfræðingar starfa nú í, eru þeir hins vegar í ákveðnu öngstræti við að tryggja gæði hjúkrunarinnar. Markviss stjórnun og fagleg forysta skiptir þá sköpum fyrir gæði hjúkrunar á hjúkrunarheimilum. Styrkur hjúkrunarfræðinga liggur í þekkingu þeirra og hinni heildrænu nálgun sem þeir beita. Niðurstöður þessarar rannsóknar geta nýst sem grunnur fyrir frekari rannsóknir á viðfangsefninu auk þess að vera mikilvægt framlag þekkingar til hjúkrunarfræðinga, hjúkrunarstjórnenda og ráðamanna öldrunarmála.To ensure quality care in nursing homes for the elderly there is a need to identify what registered nurses contribute to the quality of long-term care. The purpose of this qualitative study was to shed light on the undertakings of registered nurses in nursing homes and what their work entails. Four focus group interviews were done with a total of 22 nurses from five nursing homes. A semi-structured interview framework was used. Data were analyzed into themes. Findings reveal manifold and complex undertakings of registered nurses in nursing homes. The main theme identified was keeping all strings in one’s hand. The subthemes identified were vigilance, overview and constant surveillance and being analytical and seeing things from a new perspective. However, with the current tight economic situation in which nurses are now bound to carry out their work, they are so to speak located in a dead end street in seeking ways to ensure quality nursing care. Purposeful management and professional leadership in nursing is thus crucial for quality care in nursing homes. The strength of the work of registered nurses in nursing homes lies in their knowledge and their holistic work approach. Study findings may be used as ground for further studying the matter besides being valuable knowledge for nurse clinicians, managers, and policy makers who are in charge of the care of the elderly.B-hluti vísindasjóðs Félags íslenskra hjúkrunarfræðing

Educational and personal burnout and burnout regarding collaborating with fellow university nursing students during COVID-19 in 2020-2021

Funding Information: The research received funding from the scientific funds of the University of Iceland and the University of Akureyri. Publisher Copyright: © 2023 The Authors. Scandinavian Journal of Caring Sciences published by John Wiley & Sons Ltd on behalf of Nordic College of Caring Science.BACKGROUND: Knowledge is lacking about the effects of COVID-19 on nursing students' burnout symptoms. Burnout can lead to negative feelings and behaviours towards learning and poor mental health. AIMS: To describe and compare nursing/midwifery students' burnout, explore differences and detect predictors at two time points through COVID-19. METHODS: Students were offered participation in the spring semesters of 2020 and 2021 (N = 2046), during COVID-19. The response rate was 30-33%. By using reliable and valid instruments, the students' stress and burnout were analysed as well as the students' health and perceived support. RESULTS: Symptoms of academic burnout were higher among 1st and 2nd year BSc students in 2021. On the contrary, 3rd and 4th year students had higher academic and personal burnout than graduate students as well as than 1st and 2nd year students. Regarding academic burnout, 47% of the variability was explained by educational level, support, stress and the interactional effect of stress and support. Collaborational burnout, predicted by the students' educational level and support, explained 7% of the variability in the outcome. Additionally, educational level, and stress, predicted 52% of the variability in personal burnout. CONCLUSION: Educators or student counsellors need to facilitate effective learning practices and offer academic support, specifically during 3rd and 4th year to boost helpful coping strategies and handle uncertainty and stressors related to crises such as COVID-19.Peer reviewe

Oral anticoagulant monitoring: Are we on the right track?

To access publisher's full text version of this article click on the hyperlink belowVitamin K antagonists (VKAs) cannot be administered without regular monitoring in order to assure their efficacy and safety. Indeed, if well managed, the VKAs appear to be no less efficacious or safe than the newer direct oral anticoagulants (DOACs). Although it is claimed that no regular monitoring of the DOACs is needed, their levels are increasingly being measured under a variety of circumstances, for example, prior to surgery, in suspected overdose, to confirm effective reversal, in patients with malabsorption and to assess patient compliance. Although no therapeutic range has been identified for the DOACs, it has been demonstrated for dabigatran and edoxaban that their antithrombotic effect increases gradually with increasing concentrations and that the risk of major bleeding also gradually increases. Furthermore, it has been determined that almost all dabigatran-related thrombotic events occur in patients with the lowest quartile concentration of the drug. This suggests that to assure an ideal effect of DOACs in all patients taking them, some form of regular monitoring and dose tailoring should be performed. For the vitamin K antagonists, the best outcome is obtained using formal algorithms and centralized management. Furthermore, data suggest that replacing the standard prothrombin time as a monitoring test may increase the stability of VKA anticoagulation with consequent reduction in thromboembolism without an increase in bleeding. Thus, it is likely that the outcome of all current oral anticoagulants can be improved in the coming years by improving monitoring and tailoring their effect

History, ethiopathology and therapeutical possibilities of the Alzheimer’s disease

In this thesis the history, ethiopathology and therapeutical possibilities of the disease will be described using informations gathered from scientific articles that where collected from the MEDLINE database by the use of the PupMed search engine and official books, see references. With greater knowledge of pathoetiology, genetics and advanced imaging and diagnostic tools the diagnosis and early intervening of the disease is possible. Furthermore with understanding of the pathoetiology of the disease on the molecular level the researchers have now shifted their focus more on how we can slow down the progress of the disease or even prevent it.egységes, osztatlanáltalános orvosango

Lokaverkefni leikara : Við deyjum á Mars e. Jónas Reyni Gunnarsson í leikstjórn Stefáns Jónssonar

Lokaverkefni leikaranema við Sviðslistadeild Listaháskóla Íslands, uppsetning á verkinu Við deyjum á Mars eftir Jónas Reyni Gunnarsson í leikstjórn Stefáns Jónssonar

Starfsánægja, streita og heilsufar á breytingatímum: Rannsókn á Kragasjúkrahúsum

Efst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinnMarkmið rannsóknarinnar var að kanna hvernig hjúkrunarfræðingar og sjúkraliðar greina frá streitu, starfsánægju, heilsu og vinnu og starfsumhverfi á endurskipulagningar- og niðurskurðartímum í kjölfar efnahagskreppunnar 2008. Einnig var ákveðið að skoða hvort munur er á þessum breytum eftir starfshópunum tveimur og út frá sjálfmetnum áhrifum kreppunnar á starf og einkalíf. Jafnframt vildu rannsakendur athuga hvaða þættir spá fyrir um starfsánægju og vinnutengda streitu hjá þessum hópum. Gagna var aflað með spurningalista sem í voru mælitækin Streituvaldar í vinnu og Starfsánægjukvarðinn auk bakgrunnsspurninga. Þátttakendur voru hjúkrunarfræðingar og sjúkraliðar sem störfuðu á Kragasjúkrahúsunum vorið 2011. Svörunin var 64,7% (n=143). Flestir þátttakenda (69%) voru eldri en 45 ára og höfðu starfað í meira en 10 ár á núverandi stofnun. Þáttagreining Starfsánægjukvarðans greindi fimm þætti og kvarðans Streituvaldar í vinnu fjóra þætti. Þátttakendur voru almennt frekar ánægðir í starfi en fundu jafnframt til talsverðrar streitu. Þeir voru ánægðastir með Samstarfsfólk og óánægðastir með Laun og hlunnindi. Teljandi munur fannst ekki á hjúkrunarfræðingum og sjúkraliðum. Sjúkraliðar voru marktækt eldri, með lengri starfsaldur og voru í hærra starfshlutfalli. Hjúkrunarfræðingar voru marktækt óánægðari með Starfsframa og starfsmöguleika en marktækt ánægðari með Jafnvægi milli vinnutíma og frítíma en sjúkraliðar. Þá fundu hjúkrunarfræðingar fyrir meiri heildarstreitu en sjúkraliðar. Niðurstöður aðhvarfsgreiningar voru að streita í starfi og stuðningur deildarstjóra spáðu mest fyrir um starfsánægju en atriðin starfsánægja, líkamleg streitueinkenni, að íhuga að hætta núverandi starfi ef starf býðst á annarri stofnun, að komast ekki úr vinnu á réttum tíma vegna álags og áhrif kreppu á streitu í einkalífi spáðu mest fyrir um streitu. Niðurstöður rannsóknarinnar sýna að stjórnendur verða að vera meðvitaðir um að niðurskurður og endurskipulagning á heilbrigðisstofnunum getur haft neikvæð áhrif á líðan og starfsánægju starfsmanna. Því er afar mikilvægt að þeir styðji markvisst við bakið á starfsfólki til að hafa jákvæð áhrif á þessu sviði.------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------The purpose of this study was to explore how registered nurses (RN) and licensed practical nurses (LPN) describe job satisfaction, work-related stress, health, and working environment in times of restructuring and downsizing as a result of the economy crisis in 2008. Furthermore, to investigate and see if there was a difference between these variables within the two professions and how they describe the impact of the economic crisis on their job and private life. Data were collected with a questionnaire that incorporated the Job Stress Scale, the Job Satisfaction Scale and demographic questions. The population consisted of registered nurses and LPNs working at the hospitals in the communities around Reykjavík in the spring of 2011. The total response ratio was 64,7% (n=143), 69% of the participants were older than 45 and had been working for over ten years at the same institution. A factor analysis of the Job Satisfaction Scale revealed five factors and of the Job Stress Scale four factors. In general participants were rather satisfied with their work but experienced some stress. They were most satisfied with coworkers and least satisfied with wages and benefits. Generally the differences between RNs and LPNs were insignificant. However, LPNs were significantly older, with longer job experience and worked longer hours during the week than RNs. RNs were significantly less satisfied with professional opportunities and more satisfied with work life balance than LPNs. RNs experienced more stress at the job than LPNs. Findings from regression analysis revealed that job stress and support from nurse unit managers predicted job satisfaction while several other issues (job satisfaction, physical stress-symptoms, considering to quit the present position if a position is available at another institution, not being able to leave work at the right time due to workload and influence of economy crisis on stress in private life) influenced job stress. From the findings it can be concluded that managers must keep in mind that restructuring and downsizing in healthcare organizations can have a negative effect upon staff wellbeing and job satisfaction and therefore managers’ professional support is of great importance

Rannsókn á notkun Vallhumalssmyrsls á brunasár hjá börnum við meðferð á barnadeild og eftir heimkomu

Á síðustu áratugum hafa orðið miklar framfarir í meðferð brunasára. Þegar djúp brunasár hafa gróið og við grynnri brunasár er notkun smyrsla og feitra krema nauðsynleg. Hér á landi hefur Jurtasmyrsl verið notað á barnadeild Barnaspítala Hringsins, sem úrræði síðan 1996. Smyrslið inniheldur jurtina Vallhumal, sem er aðal uppistaðan í smyrslinu. Engar rannsóknir hafa verið gerðar á eiginleikum Jurtasmyrslsins. Tilgangur rannsóknarinnar var að skoða notkun á Jurtasmyrslinu við sárameðferð hjá börnum sem hlutu brunaáverka á árunum 2008-2012. Markmið rannsóknarinnar var að greina hvort Jurtasmyrslið er öruggt í notkun. Rannsóknin skiptist í tvo hluta, annarsvegar var hún afturvirk lýsandi rannsókn úr sjúkraskrám þar sem þátttakendur voru öll börn, 18 ára og yngri, sem komu á barnadeildina vegna brunasára á húð á árunum 2008-2012 (n=60). Skoðuð var notkun Jurtasmyrslsins og einkenni sem komu fram eftir því sem á meðferð leið og hvernig sár greru fram að útskrift. Seinni hluti rannsóknarinnar byggði á símaspurningakönnun við foreldra barna (n=5), sem hlutu brunaáverka á árunum 2011 og 2012. Þeir voru spurðir spurninga um notkunina á Jurtasmyrslinu eftir útskrift. Helstu niðurstöður gáfu til kynna að Jurtasmyrslið var notað í 87% tilfella á brunasár eingöngu eða ásamt öðrum brunaumbúðum. Niðurstöður gáfu til kynna að eitt barn (1,9%) hafði fengið ofnæmisviðbrögð við Jurtasmyrslinu og lýsti það sér í formi kláða og útbrota. Þrjú börn (5,7%) upplifðu einnig einkenni sviða og kláða af Jurtasmyrslinu, en var ráðlagt að halda notkun þess áfram. Jákvæðar ræktanir úr brunasárum voru til staðar hjá 16 börnum og höfðu þau öll notað Jurtasmyrsl. Flest börnin sem fengu brunasár þjáðust af miklum verkjum (63%), upplifðu kláða (40%) og hlutu rofinn nætursvefn (77%). Börnin (n=5) fengu öll Jurtasmyrsl á brunasár eða á gróna húð eftir útskrift. Ótímabært er að draga ályktanir af niðurstöðum rannsóknarinnar vegna smæðar úrtaks og ófullnægjandi skráninga í sjúkraskrám. Niðurstöður staðfesta notkun Jurtasmyrslsins á barnadeildinni og nauðsyn þess að gera framvirka rannsókn á áhrifum Jurtasmyrsls. Lykilorð: brunasár, barn, jurtasmyrsl, vallhumall, sárameðferð.Over the last few decades, much progress has been achieved in treatment of burn injuries. With deep burn wounds, that have healed or with shallow scalds, the use of balm and fatty creams is essential. Since 1996 has the Icelandic Children´s hospital Hringur been using Jurtasmyrsl (e. herbal balm) in their treatment of burns. The balm contains the herb Yarrow that is the main ingredient in the balm. No specific research has been done on the nature of Jurtasmyrsl. The purpose of this research was to examine the use of Jurtasmyrsl in wound treatment of children that suffered burn injuries in the period between 2008 and 2012. The objective of the research was to analyze whether it is safe to use Jurtasmyrsl. The research was divided into two parts, on the one hand retrospective descriptive method was used in the research using medical records where the participants were all children, 18 years of age or younger, that visited the children´s ward for treatment of burn wounds in the years between 2008 and 2012 (n=60). The use of Jurtasmyrsl was examined, as were the symptoms that emerged as the treatment progressed and wounds healed until patients were discharged. The later part of the research was based on phone survey questions, where parents of children (n=5), that had suffered from burn injuries in the years between 2011 and 2012, were asked questions regarding the usage of Jurtasmyrsl after discharge. The main results indicated that the Jurtasmyrsl is used on burn wounds in 87% of incidents with or without other wound dressings. Results indicates that one child (1,9%) had allergic reaction from the Jurtasmyrsl, with symptoms of sever itching and rashes. Three children (5,7%) had indication of allergic reaction but where advised to continue to use Jurtasmyrsl. Positive bacterial results from burn wounds where diagnosed from 16 children and they had all been using Jurtasmyrsl. Most children that suffered from burn injuries experienced severe pain (63%), itch (40%) and ruptured sleep (77%). The children (n=5) continued to use Jurtasmyrsl after discharge. Due to the small sample and insufficient medical records, it is premature to draw any conclusions from the results of the research. The results confirmed the extensive use of Jurtasmyrsl and the need to perform prospective research on the effect of Jurtasmyrsl. Key words: burn wound, child, herbal balm, yarrow, wound treatment